I more or less agree with your reading of this. I found it a little curious that the author didn't mention anything about researchers taking a slightly different tack, like the people who designed the Pronto, a South African-designed condom whose application is much faster than a traditional condom. Obviously condom feel is an issue in usage rates, but I suspect that speed/ease of use is at least as important. It's not like condoms take forever to put on, but the process of locating and using one can definitely interrupt the moment.

The pronto is a brilliant step in advancing product design at least. https://www.youtube.com/watch?v=kMriPq9k278

> Yeesh what an overwritten article.

So often, it seems that's what is meant by "long-form article."

Sadly true. Information that could be conveyed directly in a paragraph or two is dragged out to create a long and often dull narrative, usually without any points of reference. Condom designs don't change every year? Neither do penises. Medical gloves (whose technology derives from condom manufacturing) haven't changed much for decades either. Infection risks are mitigated with antimicrobial coatings and double-gloving. The basic problem is that condoms work well enough for most people and so there isn't that much economic incentive to launch different kinds, even before you consider the regulatory factors.

> Condom designs don't change every year? Neither do penises.

This misses the point by a mile. Particularly for someone complaining about the article having too much unnecessary information, it's bizarre that you missed the ~3 paragraphs following this that describe _why_ it's a problem that they haven't changed: low rates of satisfaction and usage for something that has considerable public health implications (particularly in the developing world).

> Medical gloves (whose technology derives from condom manufacturing) haven't changed much for decades either.

....and if more than 50% of doctors weren't using medical gloves (regulation aside) due to evidently significant issues with comfort and convenience, this would be a cause for complaint too.

> The basic problem is that condoms work well enough for most people and so there isn't that much economic incentive to launch different kinds

This is a particularly ignorant claim, even if you hadn't read the article. Low rates of condom use in situations where they're extremely important is something that any informed person is aware of (again, this is most dramatically true for things like AIDS crises in developing countries like many in Sub-Saharan Africa). As the article establishes, usage isn't great even in the developing world:

"5 percent of men and 63 percent of women who’d most recently had sex with a “new acquaintance” hadn’t used a condom. More alarmingly, 75 percent of women who weren’t using a back-up birth control method reported not using a condom the last time they’d had sex. Adults who’d had anal sex in the past year—the highest-risk sexual act with regard to HIV transmission—said they’d used condoms only 20 percent of the time."

It should go without saying that economic incentives aren't a panacea for reaching global optima: Sometimes you end up in local optima, as in this case where the risk of doing research to potentially tap into the vast market of non-condom users may not be worth it. That's not to mention the systematic under-emphasis that economic incentives have on externalities, as in this case where the public health effects of more universal condom usage wouldn't all be captured by condom manufacturers.

I'm aware of all those things. But you're assuming that people are desperate to adopt something other than existing condoms, eg in Africa. They won't, on past form. Education efforts yield a better return than any putative new condom technology.

I'm not saying they're perfect, by any means. But when you get down to it, they're not hard to use and have a high success rate when used properly. Governments and aid agencies already substantially subsidize the distribution of condoms, which subsidies should easily be enough to offset the non-capture of positive externalities by manufacturers (as if the positive externality of repeat demand due to people living longer healthier lives were not sufficient incentive).

The biggest failure in managing the spread of AIDS in Africa has not been the ongoing deficiency of condoms but the apparently completely wasted expenditure of $1.3 billion in aid monies spent on promoting sexual abstinence instead of harm reduction over the last 15 years: http://www.nytimes.com/2015/02/27/health/american-hiv-battle...

We spent over a dollar on every person in Africa to tell them we don't think they should be having sex, in defiance of all the evidence about the inefficacy of such programs, so as to satisfy a small political faction of religious extremists who also support things like instituting the death penalty for homosexuality (https://www.academia.edu/1053858/Locating_Neocolonialism_Tra... ); meanwhile suspending other kinds of educational programs. And then we look at the low rates for condom use and we conclude that the deficiency is with the condoms? Please.

Could we and should we be working to improve condoms? Of course. Are such improvements subject to the law of diminishing returns? Also, of course. You're just not going to get paradigm shifting results through busywork, any more than you're going to get order-of-magnitude improvements in wheel design. A condom is always going to be basically an elastic tube that's closed on one end, just as a wheel is always going to be a circular structure that rotates around a central axle.

I feel for the guy in the article who got unlucky and contracted HIV, but when he's talking about people iterating on things like salt, pepper, and olive oil every year - no they're not. They market it slightly differently, the basic product has seen very little change in thousands of years - much like condoms. Unless we discover drugs that are cheap and have a broad-spectrum prophylactic effect against STDs and pregnancy, we have to be realistic about the prospect of small incremental improvements rather than great leaps forward in this area.

Thanks for the summary. One of these days I should hire someone to write summaries like this. More than a one-liner, simply all the stuff that is... interesting. I guess your definition of interesting and mine line up pretty well.

There is a company that pretty much does that, give them a try: https://www.blinkist.com/

"never use a long word when a short word will do"

"if it is possible to cut a word out, cut it out."

Or, to sum up even more succinctly:

- Government regulations have stifled innovation, thereby making existing products less safe, less comfortable, and less used than they would be otherwise.

In other words, nothing new.

There's some truth to this, but your tone makes it a little hard to spot.

I'm not sure that the article provides much support for the broad claim, implied by your comment, that government regulation is always a bad idea, or that the government should get out of the condom regulation business. I for one think it's a pretty good idea for a regulator to ensure that condoms (like other health-related products) perform up to some minimum standard. The social impact of sub-standard products is too significant to leave to the market and there is good reason to think that the market would not adequately communicate the signals that consumers need in order to make rational condom-purchasing decisions in the absence of regulation.

I agree with your narrower claim that the existing condom regulations seem to be badly in need of reform. But I'm not at all convinced that they are worse than having no regulations at all.

> Government regulations have stifled innovation, thereby making existing products less safe, less comfortable, and less used than they would be otherwise.

The article implied this in tone, but in facts reported within did not make a slam dunk case. Latex is probably significantly safer in terms of blocking STD transmission, and it's also heavily understudied whether or not the sizing differences matter. I wouldn't say it's obvious government regulation is really the devil here.

You are, you just can't be lazy about it.

Pretty sure it was clear.

Government is lazy and callus about updating regulations regarding to development and testing of prophylactics. Innovative and better alternatives were taken off the market due to said regulations.

The commentary was spot on. The point of the original comment was to provide bullets without lengthy justification and citation and it was upvoted.

Then this "lazy" bullet was added and all the sudden the author needs to back up his assertion with detailed arguments? The pro-government bias here is insane.

As I said, don't be critical of government on HN unless you don't care about the group think popularity karma contest going on here.

Oh, I'm not saying there isn't a pro-government bias. I'm saying that it's just a bias, not a complete rejection. If you're pro-government, you can be lazy, but if you're against it, you can still be upvoted, you just have to work a little harder to overcome the bias.

Generally speaking I get the sense that HN readers are for an effective and efficient government. That's about as middle-of-the-road as you can get.

For anyone interested in living in a country where there is little to no government intervention are more than welcome to move to Central Africa to see what they're missing out on.

Yeah, and people who want a strong government should move to NK!

Seriously, don't you all get tired of burning the same straw man over and over again? I'm sure you don't support every possible kind of government, including Pinochet's Chile and the Khmer Rouge. It must also be democratic, somewhat respect human rights and such, no? Likewise, people who argue against them also have conditions they believe would be necessary for a stable country. You may think they are wrong, and point out why, but just saying "look at <country in shitty conditions>" is not a good argument.

So basically what I'm getting out of this is you agree with me? And possibly the majority of HN?

It's ridiculous to me how people talk like they're so far apart on their views of what a government should be, but when we really get to the nuts and bolts we're all pretty much after the same thing.

Well, I apologize, because I obviously failed to get myself understood.

My post had nothing to do with agreeing or not with you. I expressed no opinion on the issue. I was just trying to explain why I think the "why don't you move to Somalia?" is a bad argument.

Totally agree with your statement regarding the HN pro-gov't bias, unfortunately. Such is life.

Without the FDA and its outmoded regulations, there would be a flourishing of condoms for people to choose from, instead of just the three entrenched companies that can afford to deal with the gov't. If nothing else, the article details the fact that there are a LOT of people who care deeply about and are trying to solve this problem (and should be left largely unconstrained to do so).

Pro-government bias in the community? I don't see it. In fact, I see the claims of private industry fixing everything being made on the daily due to HN's bias towards startups making a difference.

What I do see is HN not taking lightly claims that someone just makes out of hand without evidence as if they are obviously the truth, no further proof needed.

I dont think anyone would make the claim that any government is beyond reproach. If you have been paying attention to the recent snowden or schwartz or any of the recent police action related articles posted on here, you would see criticism of the government hitting very high levels of (well deserved) vitriol.

>>Totally agree with your statement regarding the HN pro-gov't bias, unfortunately. Such is life.

Really? Last time I checked, most HN users subscribed to the notion that the government is slow and inefficient and does not do as good of a job as private companies in most fields.

Libertarian viewpoints tend to be heavily downvoted though, and for good reason. There are some people whose love for private enterprise and the "invisible hand of the market" blinds them to reality.

That doesn't explain why the innovation didn't happen in, say Somalia, where there are no government regulations to speak of.

The situation in Somalia can be readily explained by low incomes and decades of violence.

Which in turn can readily be explained by the lack of a strong government.

I presume you know very little about Somalia's recent history. It had a strong government from 1969 to 1991. It was a military dictatorship with a centrally planned economy ("scientific socialism"). After the regime's collapse in 1991, Somalia was essentially stateless, and there was dispersed fighting between various groups for control of various areas of Somalia. Yet, perhaps surprisingly to many people, it's not clear that things were worse under "anarchy" than under Barre's regime. For instance, life expectancy improved dramatically, as did access to health care and technology.

You appear to be confusing strength with brutality. The military dictatorship was not strong. That’s why it collapsed. In general, dictatorships tend to be weak and unstable in comparison to more democratic forms of government.

I'm not confusing the two. The government was brutal, and it was also strong. It censored the media. It nationalized all major industries. It carried out large scale terror campaigns against political dissidents and Somali clans. It suppressed civil liberties on a very wide scale.

That's a pretty facile response. Lots of African countries with "strong" governments still have tons and tons of violence.

Somalia went through a civil war in recent history. That's about the best possible example of violence caused by the lack of a strong government. Of course, violence can occur for other reasons too, so merely having a strong government is no guarantee of its absence.

Can it? On what do you base that opinion? What particular facts from the modern history of Somalia have you used to support it?

The fact that it's currently in a state of near anarchy and has been for a while.

How do you explain the improvements that have occurred since the collapse of Barre's regime? That seems to indicate that anarchy cannot be blamed for the poor conditions in Somalia compared to, say, wealthy Western nations.

I'm not defending the hypothesis that any government is better than no government. So sure, having a really really bad government could be worse for Somalia than having none at all.

That's not an explanation, that's restating the fact.

Your comment was ambiguous. I thought you were asking me for the basis of my claim that Somalia lacks a strong government. If you think the civil war doesn't have anything to do with Somalia's current problems, I'm open to being persuaded.

The civil war and the lack of a strong government are not the same. It's the former, and not the latter, which maintains them in poverty.

A civil war happens precisely because there is no strong government. It's completely bizarre to claim that there's no link between the two.

...And an abundance of strong governments who are willing to fund various factions to kill other various factions to fight a proxy war over natural resources.

Right, because Somalia has never had a government, or the lack thereof today has nothing to do with the previous government.

We really are going down the libertarian rabbit hole when even the absence of government is blamed on government.

You don't have to be libertarian to recognize that Barre's military dictatorship was not an example of a good government. From Wikipedia:

> The United Nations Development Programme stated that "the 21-year regime of Siyad Barre had one of the worst human rights records in Africa."

http://en.wikipedia.org/wiki/Siad_Barre#Human_rights_abuse_a...

I'm not trying to paint all governments with the same brush. I'm just saying that, perhaps, you don't know anything about Somalia and are just using it as a strawman against small government.

edit: it's one, single country that has had a very violent history, not a case study in deregulation of markets.

I didn’t say anything about small government or market deregulation. Small vs large is orthogonal to strong vs. weak.

That's why they don't have an industry there. But any western manufacturer could go to some lightly-regulated place, start handing out Better Condoms (tm) like candy, and then point to major improvements in user satisfaction, disease transmission rates, and so on in order to create pressure for a more careful evaluation in other markets like the US or EU.

Think back to news you've read about the deployment of improved mosquito netting and the like, which is tried out in Africa because that's where the greatest need exists.

But if there's no government intervention, then why are incomes so low, and why is there so much violence?

After the collapse of the Somali Democratic Republic in 1991, incomes increased and violence decreased.

...which means they will need children and are not focused on prevention technology